29 March 2019

Don't let the fear of injury hold you back - the benefits of tennis outweigh the risks

Playing better tennis is a goal for most of us, but are we doing enough to make sure we are injury free? And should the worst happen, what are our chances of returning to the sport we love? This week we had the opportunity to speak to the world renowned expert, Dr. Derek Ochiai, who specialises in knee, hip and shoulder injuries

Dr Derek OchiaiBad news from Julian, one of our players who only a couple of weeks ago was winning his way through matches at the ITF seniors event at the Rafa Nadal Academy by Movistar in Mallorca. A niggling knee injury has not cleared up and now he has to have surgery. Meanwhile, Rita on the LTL team, is also nursing a bad knee (though rather enjoying the opportunity to shorten points with some more aggressive net play).

Suddenly it begins to look inevitable. At some point a knee, hip, elbow or shoulder is going to play up and threaten to rob us of the sport we love.

Speaking to us from his US base in Virginia, Dr Ochiai was keen to put things in a proper perspective. 

"There is a risk of injury in pretty much any sport but there is also a decreased risk in cardiovascular events. Typically those curves would highly favour being active over not being active. A knee strain is one thing; a heart attack is a completely different issue."

If you hope to remain injury free, taking up tennis is about more than turning up on court and playing. "The first thing to realise is that you shouldn’t play tennis to get in shape. You should get in shape to play tennis."

Dr Ochiai, who was a two time US Karate National Champion and is now "more of a golfer", says tennis does not replace going to the gym. "You should take a hard look at your fitness levels, especially when you start playing. This can be be done through self-assessment, finding a personal trainer or consulting a physical therapist but however you do it you need to see where you may be deficient. A lot of people starting out in tennis have a weakness in core gluteal strength. Their back, and the muscles that connect their back to their hips, are not as strong as maybe their quad muscles. That kind of inbalance can lead to back or hip issues."

The remedial work need not be complicated. "A home regime of clam shells, planks and mini lunges can all help avoid injury. Try some gentle weightlifting - you don't need to be Arnold Schwarzenegger." Not only will you decrease your chance of injury you will "probably play better too".

Once you are playing regularly, the advice is to slowly increase the amount of tennis you play as the body acclimatises to tennis-specific stresses and strains.

So at what point should we take an injury seriously enough to see a doctor? For instance, if your knee swells up overnight would that set off the alarm bells?

"If your knee swells and it has never swollen before, yes that probably would be the time to see a professional. But if you already know you have a little arthritis and it has swollen before, there is no need to jump to see an orthopaedic surgeon. Certainly I would not play tennis for a while and take perhaps some anti-inflammatories. See if it calms down and give it a couple of weeks.

"If your knee has a locking or catching issue, if doesn't seem normal, if you can't totally straighten the leg or bend it then you should seek help. Things like this, and limping significantly, are warning bells."

All that said, playing with a long-term injury "isn't the worst thing you can do". "A lot of orthopaedic issues are the kind of smouldering, chronic injuries that have a tendency to flare up. They might just calm down over time, even if you are active. If you can tolerate it and it is already a known issue, then [carrying on playing] is not neceassarily horrible to do. But if it is an unknown problem, it would be impossible to tell without help if it was simply arthritis or something like a torn meniscus."

The good news is that with modern orthapaedic surgery, even a torn meniscus in the knee has a positive outlook. "The goal should be getting somebody back to same level of recreational tennis they were at when they injured themselves."

Sadly though Dr Ochiai is less sanguine about Andy Murray's chances of returning to the top flight of the game.

"I can see him coming back to play exhibition matches but getting back to a level where he could beat Nadal and Federer in a five set match - I don't think that is reasonable. When you have an artificial hip, which he has, whether it is metal on metal or ceramic on metal, it is not your own body. There's no further healing capacity there. If you are really active on a hip replacement it will just wear out quicker. The other issue is that all the muscles around your hip are not going to act normally. They may be close but it won't be exactly the same and that will matter when he's playing at the elite level. I don't think it is a good idea, but what's more I don't think Andy will perform at a level he would be happy to."

We hope that this is one case that warrants a second opinion, but we are much happier to accept Dr Orchiais's disgnoses of good sense when it comes to our players.

"I applaud them for choosing a sport you can play for your entire life and be as competitive with it as you want to be. Unlike some other sports, you don't have to retire from tennis. Having an activity that pushes you a little is a positive and definietly not something to be afraid of. Get in shape, play tennis, stay in shape. And if you do get injured, don't bury your head in the sand. Get it looked at!"

Dr Derek Ochia works at the Nirschl Orthopaedic Center in Arlington, VA, USA